Cerrahi Tıp Bilimleri Bölümü Koleksiyonu

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https://hdl.handle.net/20.500.12428/2266

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What is the mechanism of action of anticholinergics in the bladder – is it neurogenic or non-neurogenic?
(Ali İhsan TAŞÇI, 2014) Abdulmajed, Mohamed; Reşorlu, Berkan; Gülpınar, Murat Tolga
The human urinary bladder is a highly – compliant storage device and nerve supply to the bladder is relatively complex. Dysfunction of the nervous system could affect the urinary bladder negatively, a condition called ‘neurogenic bladder’. Among neurogenic bladder complications, urinary incontinence is the most significant factor in determining quality of life. Urinary incontinence in neurogenic bladder is explained by detrusor overactivity on urodynamic assessment. Oral anticholinergic medications are largely accepted as the cornerstone in the management of neurogenic detrusor overactivity. In this review article, we closely analyse the mechanism by which anticholinergic treatment help increasing bladder compliance and bladder capacity and reducec involuntary detrusor contraction in neurogenic bladder cases [TR] İnsan mesanesi, kompliansı yüksek, sinirsel desteği ise oldukça kompleks yapıda bir depolama organıdır. Bu bölgeyi innerve eden sinir sisteminin disfonksiyonu nörojen mesane olarak adlandırılmakta ve mesane fonksiyonlarını değişen derecelerde etkileyebilmektedir. Nörojen mesaneye bağlı oluşan semptomlar içerisinde yaşam kalitesini en çok etkileyeni idrar inkontinansı olarak bildirilmektedir. Nörojen mesanede idrar inkontinansı oluşumunun en önemli mekanizmlarından birisi ürodinamik çalışmada detrüsör aşırı aktivitesi ile izah edilmektedir. Oral antikolinerjik ilaçlar nörojen detrüsör aşırı aktivitesinin tedavisinde dönüm noktası olarak kabul edilirler. Bu derlemede nörojen mesane olgularında mesane kompliansını ve kapasitesini arttırmak ve istemsiz detrüsör kontraksiyonlarını azaltmak için kullanılan antikolinerjik tedavinin etki mekanizmasını analiz ettik
Comparison of Bicortical Headless Cannulated Screw Fixations, Tension Band Fixations, and Kirschner Wire Fixations of a Jones Fracture A Biomechanical Study
(Amer Podiatric Med Assoc, 2024) Yılmaz, Onur; Mutlu, İbrahim; Kuru, Tolgahan; Bilge, Ali; Güngör, Berna; Kızılay, Hasan; Olcar, Hacı; Erken, Hüseyin Yener
Background: The aim of study was to biomechanically compare the fixation of Jones fracture using headless cannulated screw, tension band, and two Kirschner wires.' Methods: A total of 60 fourth-generation, fifth metatarsal synthetic bone models were divided into three groups according to the fixation techniques. A vertical load, oriented from plantar to dorsal and lateral to medial, was applied to the metatarsal specimen that were potted with molding material. The stiffness and fatigue values were compared between the three fixation groups. Results: In the plantar to dorsal load test, the stiffness values were found to be significantly higher in Group 1 compared to the other groups (P = .034, P = .013). No significant difference was found in the analysis in terms of fatigue values in plantar to dorsal load testing (P = .348, P = .416). No significant difference was found between compression screw and tension band groups in lateral to medial loading test, in terms of stiffness and fatigue values (P = .096, P = .762). However, the stiffness values and fatigue values of these two groups were found to be statistically significantly higher than the Kirschner wire group (P = .003, P = .002, P = .016, P = .023). Conclusions: The result of this study showed that the bicortical fixation of headless compression screw provides a more stable fixation than other fixation methods, especially in plantar to dorsal loading. (J Am Podiatr Med Assoc 114(6), 2024; doi:10.7547/22-201)
Re: Akyurek M et al. Influence of palmar plate injury on outcomes of zone 2 flexor tendon repair. J Hand Surg Eur. 2024, doi:10.1177/17531934241300510 Reply
(Sage Publications Ltd, 2025) Akyürek, Mustafa; Hafız, Güneş; Sayan, Mihrican
[No abstract available]
Moxifloxacin-Impregnated Contact Lenses for Treatment of Keratitis in Rabbit Eyes
(Wiley, 2025) Erdoğan, Hakika; Güngör, Buket; Sağbaş Suner, Selin; Sılan, Coşkun; Saraydın, Serpil U.; Saraydın, Dursun; Ayyala, Ramesh S.; Şahiner, Nurettin
Moxifloxacin (MOX) was loaded into commercial contact lenses (CLs) via supercritical carbon dioxide (ScCO2) to attain MOX-impregnated CL for keratitis treatment. This study aimed to investigate Pseudomonas keratitis treatment with MOX-impregnated CL compared to the traditional eyedrop administration. MOX impregnation was accomplished employing optimum parameters of 2.5 h drug exposure time, 25 MPa pressure, and 313 K for ScCO2 conditions using ethanol co-solvent rendering sustainable delivery, up to 7 days at effective dosage formulation. The MOX-impregnated CL was found to be safe with no significant toxicity on fibroblast cells after 5 days of contact time. Bacterial viability in vivo keratitis treatment in rabbit eyes was significantly decreased to 10(2) from 10(9) CFU/cornea for MOX-impregnated CL treatment, almost similar to exhaustive conventional 0.5% MOX eye drop treatments. The MOX-impregnated CL treatment revealed no conjunctival hyperemia, edema, or secretion for all eyes in the relevant group, and transparent cornea with no keratitis focus was obtained for two of the eyes (n = 6). The normal histological structure was seen with MOX-impregnated CL treatment on healthy eyes. Moreover, polymorphonuclear cell infiltration observed in keratitis eyes without any treatment was significantly decreased to a few polymorphonuclear cells in the groups treated with MOX eyedrops and MOX-impregnated CL.
Investigation of Human Hair by Laser-Induced Breakdown Spectroscopy: Qualitative and Quantitative Analysis of Content Element in Human Hair
(Wiley, 2025) Arbi, Ines; Yümün, Gündüz; Sezgin, Nursel
Human hair is a significant biological sample in forensic science, biomedical research, and the cosmetic industry, with the presence of essential nutrients like zinc, copper, and silicon being indicative of health. This study aimed to investigate the elemental composition of human hair using Laser-Induced Breakdown Spectroscopy (LIBS) to assess differences across age groups. Nine volunteers provided hair samples, which were analyzed using the Foster + Freeman ECCO2 LIBS system. Quantitative analysis of elemental concentrations was performed, and elemental ratios, such as Mg/Ca, Mg/Si, Mg/Fe, and Fe/Mn, were calculated to compare the samples. Results demonstrated that LIBS is a fast, accurate, and non-destructive method for detecting and quantifying mineral elements in human hair. The study highlights age-related differences in elemental concentrations, offering insights into the use of hair analysis for monitoring nutritional and health status. LIBS could be a promising tool for further studies in clinical and forensic applications.
Virgin ureter vs. non-virgin ureter? A comparative analysis on complications and failure of retrograde intrarenal surgery: a multicentre case-control study from RIRSearch Group
(Springer, 2025) Teke, Kerem; Çınar, Naci Burak; Çınar, Önder; Akgül, Murat; Başataç, Cem; Şimşekoğlu, Muhammet Fatih; Çakır, Hakan; Sıddıkoğlu, Duygu; Sancak, Eyüp Burak
It is unclear whether ureteral virginity has an effect on retrograde intrarenal surgery (RIRS). We aimed to evaluate the impact of ureteral virginity on RIRS outcomes in a multicenter study. Data from the RIRSearch study group database were retrospectively reviewed. Patients with a history of endoluminal interventions or extrinsic ureteral surgery were categorized as having a non-virgin ureter, while those without such histories were classified as virgin ureters. Case-control matching was performed based on age, gender, uretral access sheath size, and stone characteristics. Demographic, clinical, surgical and complication data were compared after-matching. A total of 894 procedures were included, with 119 (13.3%) involving non-virgin ureters. Pre-matching, the non-virgin ureter group had higher mean age (50.6 +/- 13.2 vs. 46.6 +/- 13.6 years) and Charlson comorbidity index >= 2 (51.3% vs. 40.4%). In addition, number of stones, total-stone volume and rate of multiple stone localization were significantly higher in non-virgin ureter group. Operation time, hospital stay, surgical failure, need for auxiliary treatment, and perioperative complications were significantly higher in non-virgin ureter group (p < 0.05). After case-matching, perioperative complications (18.7% vs. 5.3%), hospital stay (1.54 +/- 1.30 vs. 1.18 +/- 0.98 days), and auxiliary treatment requirements (20% vs. 8.4%) remained significantly higher in non-virgin ureter group (p < 0.05). There was no significant difference in postoperative complication rates (17.3% vs. 19.8%) or surgical failure rates (36% vs. 26%). Non-virgin ureters were associated with higher perioperative complication rate, longer hospital stays and increased need for auxiliary treatments during RIRS. Patients with non-virgin ureters may be informed about these potential risks before surgery.
Intracameral medications in cataract surgery
(Springer, 2025) Bektaş, Çağlar; Yüksel, Erdem
PurposeTo review the indications, dosages, and safety profiles of intracameral drugs used during cataract surgery.MethodsA narrative review was conducted, evaluating published clinical studies, review articles, and guidelines related to intracameral drug use in cataract surgery. The analysis focused on drugs commonly used for anesthesia, mydriasis, inflammation control, and intraoperative complication management. Special consideration was given to their utility in high-risk surgical scenarios, such as small pupils, intraoperative floppy iris syndrome, white or pediatric cataracts, and cases with zonular weakness.ResultsIntracameral drugs have proven beneficial in achieving effective anesthesia, maintaining pupil dilation, and controlling inflammation during cataract surgery. Their use is particularly advantageous in complex cases, including those with corneal opacity, posterior capsular rupture, or combined procedures like minimally invasive glaucoma surgery and premium IOL implantation. When prepared and administered properly, these agents contribute to safer and more efficient surgeries. However, improper preparation or dosing can lead to ocular toxicity, highlighting the importance of meticulous handling.ConclusionIntracameral drug administration is a valuable adjunct in cataract surgery, enabling surgeons to manage routine and complex cases more effectively. Understanding their appropriate use and potential risks is essential to maximize patient safety and surgical success.
Bariatric Surgery and Remission of Metabolic Syndrome: A Meta-analysis of Randomised Controlled Trials and Prospective Studies
(Springer, 2025) Dean, Yomna E.; Mohamed, Mohamed I.; Shokri, Abdulrahman; Nassar, Moussa; Omayer, Abu; Shahid, Maryam; Sharif, Arsalan; Güvem, Asım Eren
Background Studies have discussed the efficacy of bariatric surgery (BS) in remission of individual components of metabolic syndrome (MS). We aimed to analyse the prevalence of MS following BS. Methods On October 5, 2023, we conducted a literature search on PubMed, Scopus, Web of Science, and Cochrane. RevManv5.4 was used for the analysis. Results MS patients who underwent BS had lower odds of MS within the first year post-BS (OR 0.14, 95%CI 0.12-0.17); patients who had a preoperative BMI < 50 showed a higher reduction in MS post-BS compared with patients who suffered from super obesity (OR 0.12 versus OR 0.17). Older patients (age > 42) had lower odds of MS post-BS compared with younger patients (OR 0.05 versus OR 0.17). There was not a difference in MS prevalence between 1 and 2 years postoperatively (OR 1.07, 95%CI 0.72-1.58). Asians reported the highest reduction in MS post-BS (OR 0.08). MS patients who received medical treatment had three times the odds of having MS compared with patients who underwent BS. Patients who had BS reported a decline in their anti-hypertensives and oral anti-diabetic drugs (OR 0.26, 95%CI 0.15-0.46, OR 0.11, 95%CI 0.07-0.16, respectively). There was not a significant difference in MS prevalence between patients who underwent RYGB and those who had SG (OR 2.16, 95%CI 0.74-6.26). Conclusions BS is superior to medical treatment in the remission of MS. Age, preoperative BMI, and country of origin affect the rates of MS remission. BS results in a sustainable resolution of MS across 1, 2, and 5 years post-surgery. A tailored approach is warranted to achieve the best outcomes.
Ultrasound-guided serratus posterior superior intercostal plane block for unilateral dorsal thoracic myofascial pain
(Edizioni Minerva Medica, 2025) Sayan, Mihrican; Sayan, Ozan; Erbaş, Mesut
[No abstract available]
The effects of systemic ozone application and hyperbaric oxygen therapy on avascular necrosis of the femoral head: An experimental study in the vascular deprivation of the rat femoral head model
(Turkish Joint Diseases Foundation, 2025) Yılmaz, Onur; Erken, Hüseyin Yener; İçkin Gülen, Meltem; Güven Bağla, Aysel; Adalı, Yasemen; Kuru, Tolgahan
Objectives: This study aims to assess the effects of systemic medical ozone (O3) application and to compare its effects with hyperbaric oxygen (HBO) therapy for preventing avascular necrosis of the femoral head in a rat model. Materials and methods: A total of 50 male Wistar albino rats were divided into six groups including five rats in each control and sham-operated control group and 10 rats in the remaining four groups: (i) control group, (ii) sham-operated control group, (iii) avascular necrosis group, (iv) intraperitoneal ozone given avascular necrosis group, (v) HBO therapy given avascular necrosis group, and (vi) intraperitoneal ozone and HBO given avascular necrosis group. We surgically induced osteonecrosis by cutting the ligamentum teres and placing a tight ligature around the femoral neck. At Week 11, we harvested femoral heads bilaterally from each animal and performed a macroscopic, histological evaluation and histomorphometric, immunohistochemical analysis. Results: The intertrabecular mesenchymal cell ratio was substantially higher in the O3 group than that of all other groups in the histological evaluation (p<0.05). Group O3 had also significantly more CD31-positive stained new vasculature than other groups, with the exception of the HBO therapy group, according to the immunohistochemical analysis (p<0.05). Conclusion: The results of this experimental study suggest that the application of medical ozone alone may have a positive effect on new vessel formation and the repair process and may be more beneficial than HBO therapy and HBO+O3 therapy in the vascular deprivation of the rat femoral head model. © 2025 All right reserved by the Turkish Joint Diseases Foundation
Predicting New-Onset Atrial Fibrillation in Patients with Coronary Artery Bypass Graft: the Precise-Dapt Score
(National Scientific Medical Center, 2024) Küçük, Uğur; Şahin, Serpil
Aim: Postoperative new-onset atrial fibrillation (POAF) after isolated coronary artery bypass graft surgery (CABG) is associated with adverse events. The Predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score is used to predict the bleeding risk after dual antiplatelet therapy and has been associated with arrhythmias in recent years. Therefore, the present study sought to investigate the association between the PRECISE-DAPT score and POAF after coronary artery bypass graft surgery. Materials and methods: 350 patients who underwent CABG were retrospectively screened. After exclusion criteria, 135 patients were included in the study. A total of 135 patients who underwent on-pump CABG were divided into two groups: patients with POAF and those without POAF. The PRECISE-DAPT score was calculated for each patient, and intergroup comparisons of the calculated scores were performed. Results: POAF was detected in 66 patients out of 135. Patients with POAF had longer hospital stays. PRECISE-DAPT score was higher in the patients with POAF compared to the patients without POAF (p<0.001). PRECISE-DAPT score was determined to be a predictor of POAF after CABG (odds ratio [OR]: 1.305; 95% confidence interval [CI]: 1.268–2.030; p<0.001). The PRECISE-DAPT score for POAF risk had a sensitivity of 60% and a specificity of 79% at cut-off values of 14.5 and above. Conclusion: An increased PRECISE-DAPT score may be used as a predictive score for POAF that may develop during hospital stay after on-pump CABG. © 2024, National Scientific Medical Center. All rights reserved.
Evaluating Auricular Conchal Cartilage Grafts in the Surgical Management of Pediatric Orbital Floor Fractures
(Lippincott Williams and Wilkins, 2025) Akyürek, Mustafa; Battal, Buruç Barkın; Hafiz, Güneş
Pediatric orbital floor fractures present unique challenges due to ongoing craniofacial growth and the need for reconstructive materials that provide stability while minimizing long-term complications. This retrospective study evaluates the outcomes of auricular conchal cartilage grafts in the surgical management of pediatric blowout fractures. Pediatric patients aged 7 to 16 years who underwent orbital floor reconstruction with conchal cartilage grafts between October 2013 and September 2023 were analyzed. Clinical data, computed tomography findings, surgical details, and postoperative outcomes were reviewed. Among 31 patients diagnosed with blowout fractures, 8 underwent surgical repair using conchal cartilage grafts. The mean age of surgically treated patients was 11.8 years, with an approximate orbital defect size of 2.8 cm2. The mean follow-up period was 25 months. No postoperative infections or donor site deformities were observed. In long-term follow-up, 1 patient exhibited both diplopia on inferolateral gaze and enophthalmos. The use of auricular conchal cartilage provided a structurally compatible, low-morbidity alternative to traditional graft materials. Its inherent concave shape and ease of harvest make it a viable option for pediatric orbital floor reconstruction. The findings of this study support the use of conchal cartilage as a reliable autologous graft for orbital floor repair in pediatric patients; however, further studies with larger patient cohorts and comparative analyses are required to better define its long-term outcomes and optimal indications. Copyright © 2025 by Mutaz B. Habal, MD.
Modified Dermal-Fat Flap Suspension Technique for Internal Nasal Valve Dysfunction: A Comparative Study With Conventional Cartilage Grafting
(Lippincott Williams and Wilkins, 2025) Akyürek, Mustafa; Çakır, Bahadır; Hafız, Güneş; Tavas, Ozan
Iatrogenic internal nasal valve (INV) dysfunction is a significant complication after nasal surgery, often necessitating revision surgeries involving cartilage grafting, which carries high risks of complications such as mucosal synechiae, septal perforations, and chronic inflammation. This study evaluates the efficacy of a modified dermal-fat flap suspension technique as an alternative to conventional cartilage grafting for INV reconstruction. A retrospective review was conducted of 30 patients treated between March 2019 and March 2023, including 8 patients who underwent the modified dermal suspension technique and 22 who received spreader grafts. Preoperative and postoperative nasal obstruction symptom evaluation scores were statistically analyzed using the Mann-Whitney U test. While both groups demonstrated significant postoperative improvements, no statistically significant differences were found between the groups. The modified technique, performed under local anesthesia, was associated with fewer complications and avoided extensive cartilage grafting or mucosal dissection, making it particularly suitable for patients with advanced age, high ASA scores, or complex surgical histories. Common complications included transient orbital edema and rare cases of skin discoloration, which resolved over time. Despite a small sample size and reliance on subjective nasal obstruction symptom evaluation scores, this study highlights the potential of the modified dermal-fat flap suspension technique as a less invasive, effective alternative for managing INV dysfunction, especially in high-risk patients. Further studies with larger cohorts and objective measures are needed to validate these findings. Copyright © 2025 by Mutaz B. Habal, MD.
Correction to: The Neuroprotective Effect of Coumaric Acid on Spinal Cord Ischemia/Reperfusion Injury in Rats (Inflammation, (2015), 38, 5, (1986-1995), 10.1007/s10753-015-0179-0)
(Springer, 2025) Güven, Mustafa; Şehitoğlu, Müşerref Hilal; Yüksel, Yasemin; Tokmak, Mehmet; Aras, Adem Bozkurt; Akman, Tarık; Gölge, Umut Hatay
The authors have noticed that there is a mistake in the material method of the article. While writing the surgical procedure of the ischemia, the time was mistakenly written as 20 minutes in 2, 3 and 4 groups, in the Material and Method section. The correct period of time should be 45 minutes in 2, 3 and 4 groups in the article. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
Evaluation of DNA damages in congenital hearing loss patients
(Elsevier B.V., 2021) Çağlar, Özge; Çobanoğlu, Hayal; Uslu, Atilla; Çayır, Akın
In the current study, we aimed to compare the level of genetic damages measured as micronucleus (MN), nucleoplasmic bridge (NPB), and nuclear bud formation (NBUD) in congenital hearing loss patients (n = 17) and control group (n = 24). The cytokinesis-blocked micronucleus assay (CBMN) was applied to the blood samples to measure the frequency of the markers in both groups. The frequencies of MN of hearing loss patients were found to be consistently significantly higher than those obtained for the control group (p < 0.0001). Similarly, we found significantly higher frequency of NPB in patients was obtained for the patient group (p < 0.0001). Finally, the frequencies of NBUD in patients is significantly higher than the level measured in the control group (p < 0.0001). Furthermore, the age-adjusted MNL, BNMN, NPB, and NBUD frequencies in the patients were significantly higher than those obtained in the control group. We observed that the frequency of MN in patients was positively correlated with NBUD frequency which may indicate a common mechanism for these biomarkers in the patient group. We found, for the first time, that there were statistically significant higher levels of MN, NPB, and NBUD in sensorineural hearing loss patients. Since the markers we evaluated were linked with crucial diseases, our findings might suggest that sensorineural hearing loss patients are susceptible to several crucial diseases, especially cancer. Furthermore, the results demonstrated the significance of the MN, NPB, and NBUD level and thus provides a potential marker for the diagnosis of congenital hearing loss patients.
CHEST INJURIES ACCOMPANYING BLUNT SPINAL TRAUMA
(Turkish Spine Society, 2021) Kapıcıbaşı, Hasan Oğuz; Malçok, Ümit Ali
Objective: Only a few studies in the literature have evaluated chest injuries accompanying blunt spinal trauma. We aimed to evaluate chest injuries observed concomitantly with spine injuries as well as reveal their clinical importance. Materials and Methods: Eighty-eight patients, who were treated and followed up by the authors after being admitted to the emergency department because of severe blunt spinal trauma, were evaluated retrospectively. Results: Data from a total of 55 patients [30 (54.5%) male and 25 (45.5%) female] who met the study criteria were included. The mean age of patients was 58±15.8. Falling from height was the most common cause of trauma in 32 patients (58.2%) and was significantly more frequent than other causes such as traffic accident, assault, non-vehicle traffic accident, and motorcycle accident (p<0.001). Spinal fracture was observed in 38 patients with severe blunt spinal trauma (69.1%), while ligament and other soft tissue damage was found in 17 patients (30.9%). Spinal fractures were significantly more frequent in the thoracic vertebra (n=28; 50.9%) compared to other regions such as the cervical and lumbar spine (p<0.001). It was observed that chest injury accompanied 33 (60%) patients who experienced blunt spinal trauma. When the thoracic region was classified as per injured tissues; rib fracture (n=10; 30.3%) and pulmonary contusion (n=6; 18.2%) were observed most frequently. Conclusion: Patients with thoracic spinal fractures should be considered at a high risk for chest injury, and this group of patients should be prioritized because of the possible life-threatening complications. In our study, we concluded that the rate of falling from height increased in the elderly group, as well as neurological losses. Moreover, the rate of neurological deficit following thoracic vertebral damage due to falling from height kept increasing especially in the elderly group.
EFFECTS OF LUMBAR MICRODISCECTOMY ON SPINOPELVIC PARAMETERS
(Turkish Spine Society, 2021) Malçok, Ümit Ali; Akar, Ali
Objective: One of the causes which accelerates spinal degeneration process is lumbar disc hernia (LDH). In this study, we observed the changes in spinopelvic parameters one month after single-level lumbar microdiscectomy (LM). Materials and Methods: Standardized bilateral standing scoliosis radiography images of 19 patients, which were performed before and 1 month after LM operation, were evaluated retrospectively. Sagittal vertical axis and coronal vertical axis distances, thoracic kyphosis, lumbar lordosis, pelvic incidence, sacral slope and pelvic tilt angles were measured with Surgimap software. Results: There was a positive correlation between pre-and post-LM values of all spinopelvic parameters included in the study. In comparative tests however, the difference was found to be not statistically significant. As a result, despite LM operation slightly improved spinopelvic parameters in the first month, there was not a significant change overall. Conclusion: LDH is known to worsen the degenerative process in spine. LM as a treatment option is seen to alleviate this degenerative process by slowing down the deterioration in spinopelvic parameters.
New results for monogenic diabetes with analysis of causative genes using next-generation sequencing: a tertiary centre experience from Turkey
(Springer, 2021) Karakılıç, Ersen; Saygılı, Emre Sedar; Sılan, Fatma; Önduç, Gonca Gül; Ağcaoğlu, Uğurcan
Background: Although monogenic diabetes accounts for a small proportion of diabetes cases, accurate diagnosis may significantly change treatment. This study aimed to contribute to knowledge about the genotype-phenotype relationship in monogenic diabetes. Methods: This study used data from a tertiary centre in Turkey. Genetic analysis outcomes for 36 patients were evaluated. The panel included 23 genes related to maturity-onset diabetes of the young (MODY), neonatal diabetes, and some genes related to hyperglycemic hypoglycemia. The next-generation sequencing method was used after DNA isolation from the peripheral blood. Results: Mutations were identified in 19 (52.8%) of 36 patients. Of the 19 mutations, 7 (36.8%) were new mutations. A total of 20 cases met the MODY clinical criteria, and mutations were identified in 11 (55%) of them. In total, nine patients had more than one mutation. Mutations were identified on the ABCC8 (n = 7), PDX1 (n = 6), GLIS3 (n = 6), ZFP57 (n = 5), GCK (n = 4), HNF1A (n = 3), GLUD (n = 3), and HNF4A, KLF11, NKX2-2, and INSR genes (n = 1 each). Conclusion: Our findings highlight a broad clinical and genetic spectrum of MODY, and genetic analysis may provide a better understanding of diabetes and improve the individualised treatment approach.
Comparison of Urodynamics Parameters with Intrafascial or Extrafascial Hysterectomy Techniques
(Mary Ann Liebert Inc., 2021) Erin, Recep; Ünsal, Mesut Abdulkerim; Güven, Süleyman; Aran, Turhan; Bozkaya, Hasan
Objectives: The aim of this study was to compare urodynamics parameters at pre-and postoperative periods in patients undergoing intrafascial or extrafascial abdominal hysterectomy. Background: Hysterectomy carries the risk of damage to the pelvic splanchnic nerve, which leads to the development of urinary incontinence. Materials and Methods: Women scheduled for total abdominal hysterectomy were randomized to intrafascial (n = 24) and extrafascial (n = 27). All of the 10 urodynamics parameters investigated in the two techniques at pre-and postoperative periods were compared. p < 0.05 was chosen to represent the statistical significance for each of the variables. Results: We observed by urodynamics investigation at preoperative and sixth month postoperative periods no urinary incontinence in patients subjected to intrafascial or extrafascial total abdominal hysterectomy. There was no difference between the two techniques with respect to maximum detrussor pressure, maximum abdominal pressure, strong micturition requirement, vesical compliance, detrusor compliance, maximum vesical pressure, first sensation of bladder filling, first desire to void, and strong desire to void (p > 0.05). Maximum bladder capacity in the intrafascial technique was significantly higher than in the extrafascial technique (p < 0.05). Conclusion: No significant relationship was found between the two groups with respect to increase of stress or urge urinary incontinence symptoms and subsequent incontinence after hysterectomy.
The Impact of Stone Density on Operative Complications of Retrograde Intrarenal Surgery: A Multicenter Study with Propensity Score Matching Analysis
(Mary Ann Liebert Inc., 2022) Başatac, Cem; Özman, Oktay; Akgül, Hacı Murat; Özyaman, Onur; Çınar, Önder; Can, Günay; Sancak, Eyüp Burak
Background: The aim of the study was to evaluate the impact of stone density on operative complication rates in retrograde intrarenal surgery (RIRS). Materials and Methods: A total of 473 consecutive patients undergoing RIRS for the treatment of upper tract urinary stones were included. To adjust for baseline confounders, one-to-one propensity score matching was performed. After matching, the patients were divided into two groups according to stone density (low density [LD] group, ≤970 Hounsfield unit [HU]; high density [HD] group, >970 HU). The patients' demographics, stone-related features, stone-free rates, and intraoperative and postoperative complication rates were compared between the groups. The primary objective was to evaluate whether the intraoperative and postoperative complication rates were higher in patients whose stone density was greater than 970 HU. Results: After propensity score matching, 170 of 210 LD and 170 of 263 HD patients undergoing RIRS were included. The baseline characteristics did not differ significantly between the groups. There were no significant differences between LD and HD patients with respect to intraoperative (5.9% and 8.8%, respectively; P = .29), postoperative (10.6% and 15.3%, respectively; P = .14), and overall complication rates (15.2% and 21.1%, respectively; P = .16). Stone-free status was achieved in 143 patients (84.1%) in the LD group and 148 patients (87%) in the HD group; the difference was not statistically significant (P = .27). Conclusion: Our results show that RIRS is a safe and effective minimally invasive procedure for the treatment of upper urinary tract stones, even in HD stones.

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